Tracheostomy tube



Feb. 16, 1965 N. z, KQENIG 3,169,529

TRACHEOSTOMY TUBE Filed May 27, 1963 2 Sheets-Sheet 1 INVENTOR.

Feb. 16, 1965 N. z. KoENlG 3,169,529

TRAcHEosToMY TUBE Filed May 27, 1963 2 SheeiS-Shee'b 2 www rmel/5yUnited States Patent O 3,169,529 TRACHEOSTOMY TUBE Norman Z. Koenig,1941 Malcolm Ave., Los Angeles 25, Calif.

Filed May 27, 1963, Ser. No. 283,436 3 Claims. (Cl. 12S-351) Thisinvention relates to improvements in a tracheostomy tube used forbreathing by patients through an opening, surgical or otherwise, in thetrachea, and which also permits simultaneously or otherwise, theadministration of gases or other vaporized medications to patientsthrough the tracheostomy tube.

Current tracheostomy tubes are made out of metal and have several partsrequiring periodic removal and insertion, all to the Agreat discomfortof the patient. For example, typical conventional tracheostomy tubesrequire the use of a stylet to provide a smooth surface and to preventthe edges of the end of the conventional metal tracheostomy tubes fromcutting into the inside membraue of a patients trachea upon insertion.Thus, the stylet must be used for 4the insertion of the conventionaltracheostomy tube. During all the time that the tracheostomy tube, witha stylet inside, is being inserted into a patients trachea, the patientis unable to breathe through the tracheostomy tube, since the styletcompletely Iblocks the passage of air through the tube and thus blocksthe passage of air through the trachea.

Further, each stylet is made in a size tailored to lit a particular sizeof tracheostomy tube. Thus, once a tracheostomy tube is being used, astylet of the proper size must -be kept immediately available for use incase of reinsertion of the tracheostomy tube in situations where thetracheostomy tube may be inadvertently dislodged. It is customarypractice to tape a stylet of the proper size to the patient or to hishospital bed to make sure that this vital component is readily availableto reintroduce a tracheostomy tube should the tube become dis lodgedfrom the patient. Such a dislodgement might very well be a disaster tothe patient.

Another disadvantage of the conventional tracheostomy tube is thehandicap to surgeons because such tubes are readily plugged up while inuse over a period of time. Therefore, periodic removal and reinsertionis required of such tracheostomy tubes. Additional disadvantages ofconventional tracheostomy tubes are that such tubes must bere-sterilized each time before being used and that such tubes areconventionally made from metals and are inexible. Consequently,considerable trauma is caused by such tubes to the fragile tissues ofthe trachea and surrounding areas of the body.

It is therefore, an object of this invention to provide a tracheostomytube which prevents any obstruction .of the breathing of a patient whilethe tube is being inserted or removed.

Another object of this invention is to provide a tracheostomy tube whichdispenses with the need of an occluding stylet, which may be easilymisplaced, for insertion of a tracheostomy tube, and which permits thepatient to breathe while the tube is being inserted or removed.

A further obiect of this invention is to provide a tracheostomy tubewhich may be made of a relatively soft material, such as a plastic,instead of metal, which will considerably reduce trauma to body tissuesof the patient.

A still further object of this invention is lto provide a tracheostomytube which is disposable and need be used only once, thereby dispensingywith the necessity of repeated sterilization of conventionaltracheostomy tubes.

A still further object of this invention is to provide a tracheostomytube which may be manufactured at relatively little cost and is easy toassemble and to use.

CII

3,169,529 Patented Feb. 16, 1965 A still further object of thisinvention is to provide a tracheostomy tube which permits theadministration of gases or other vaporized medications while the patientis otherwise breathing through the tracheostomy tube.

These and other objects will be more readily understood by reference tothe following description and claims, taken in conjunction with theaccompanying drawings forming a part hereof, in which FIG. 1 is a sideelevational view of an embodiment of my invention showing the innercannula member partly inserted into the outer cannula member.

FIG. 2 is a View similar to FIG. l but showing the inner cannula memberfully inserted into the outer cannula member so -that the exible leavesare fully expanded at the end of the outer cannula member and in alocked position, with hook members.

FIG. 3 is an enlarged section of FIG. 2.

FIG. 4 is an end view of my invention as shown in FIG. l illustratingthe leaf members with air spaces between.

FIG. 5 is an enlarged sec-tion similar to FIG. 3 showing an alternatemeans of locking my invention in the locked position and fully inserted.

FIG. 6 is a view similar to FIG. 5 showing my invention in an unlockedposition.

FIG. 7 is another enlarged section similar to FIG. 3 showing anothermeans of locking my invention in the locked position.

FIG. 8 is a section taken on line 8 8 of FIG. 7.

FIG. 9 is a perspective view of the locking means shown in FIG. 7 in theunlocked position.

FIG. l0 is an elevational view partly in section showing a modificationof my invention equipped with a conduit for passage of gases.

With reference to the drawings, the tracheostomy device 10 has an innercannula member 12 with a bore 14 which -is insertable into the bore 16of outer cannula member 18. Both the inner and outer cannula members arecurved in accordance with the inside contour of a persons trachea.

The inner end 20 of the inner cannula member 12 terminates in an orice22 having approximately the same diameter as the bore 14 of the innercannula member 12. The outer end 24 of the inner cannula member 12 isprovided with a flange 26 which is slightly convex.

The inner end 28 of the outer cannula member 18 is formed into the shapeof a cone with exible leaves 30 and interspaces 32. The outer end 34 ofthe outer cannula member 18 is provided with a ange 36 which is slightlyconvex to correspond to the flange 26 of the inner cannula member and isslightly larger than the flange 26. l

The inner cannula member 12 is suiciently long so that when it isinserted as far as it can go into the outer cannula member 18 so thatflange 26 touches flange 36, the inner end 20 of the inner cannulamember 12l bears against leaves 30 and spreads them apart in a distendedor expanded position. Upon removal of the inner cannula member 12, theleaves 30 return to their `original position forming a cone as shown inFIG. 4 of the drawings.

When it is desired to lock the inner cannula member 12 in place afterbeing fully inserted into the outer can-I nula member 18, my inventionprovides several alternate types of lock mechanisms suitable for thispurpose.

One suitable lock mechanism comprises a modification of ange 26 which isprovided with hooks 38 projecting downward from the lower surface of theflange 26. The flange 36 is formed with corresponding hooks 40 prohjecting upwards to engage with hooks 38 when the inner cannula member 12is inserted fully into the outer cav-nice nula member 18, therebylocking the inner cannula member 12 in place.

Another locking means comprises a wing nut securing the inner cannulamember 12 in place. In this modification, the outer circumference of theouter end 34 of the outer cannula member 18 is provided with threads 42.These threads 42 mesh with corresponding threads 44 contained inside awing nut 46. The wing nut 46 has an inner annular lip 48 at its topwhich presses against the outer end of the inner cannula member 12 andkeeps it in position when the wing nut 46 is screwed ldown the outer endof the outer cannula member 18.

A further alternate locking means of the tracheostomy device is a breechlock mechanism consisting of a platform 50 and a breech member 52. Theouter end of the outer cannula member 18 is formed into the platform t)which has an orifice 54 registerable with the bore 16 of the outercannula member 18. The two longer parallel sides 56 of the top surfaceof the platform 5t) are formed into longitudinal lips 58 with overhangs60 to define a channel 62.

The breech member 52 has two projecting arms 64 which are slidable alongthe channel 62. The projecting arms 64 are provided with shoulders 66which correspond to grooves 68 cut into the outer circumference of theouter end of the inner cannula member 12. A tab handle '70 formed at thebase of the breech member 52 provides a means for easily moving thebreech member in and out of locking position. When the breech member isinserted into channel 62 and pushed into locking position, shoulders 66are pushed against grooves 68, thereby producing a friction-fit whichmaintains the inner cannula member 12 in place inside the outer cannulamember 13.

My invention also provides a means for easily administering variousgases or vaporized medications to a patient through his trachea, whileat the same time permitting the patient to breathe air normally throughthe bore of the inner cannula member 12. Preferred means for doing thisare provided for by modifying either the inner cannula member 12 or theouter cannula member 1S with a conduit 72 formed in the walls of eithermember and running lengthwise from one end to the other.

As shown in FIG. 10, the conduit 72 is illustrated in the Wall of theinner cannula member 12. The conduit 72 terminates at the outer end ofthe inner cannula member 12 with a bead 74, preferably without a neck,which provides a connection to a conventional rubber tube 76 leading toa conventional source of various gases contained in a cylinder underpressure. The other end of the conduit 72 terminates in a hole 7S.

All of the various parts making up the tracheostomy device, includingthe various locking mechanisms, may be made out of any suitablematerial, preferably plastics of suitable types such as polyethylene,polypropylene, nylon, or polystyrene. Such materials as fiberglass orhard rubber are also suitable. Flexible metallic alloys made of metalssuch as aluminum, tantalum, or other suitable metals, may also be used.

In the operation of my tracheostomy device, the outer cannula member 18with or without the inner cannula member 12 inserted, is inserted intoan opening in a patients trachea. In the case where the inner cannulamember 12 is not in place, the outer cannula member 18 is inserted toits full length through the patients trachea. Since the outer cannulamember 13 is made of a relatively soft material as compared to a rigidmetal, namely, a suitable plastic, this insertion considerably reducestrauma to the patient. The cone shaped inner end of the outer cannulamember 18 slips into place very easily, due to the fact that thematerial used to construct the outer cannular member 1S is of arelatively soft and flexible nature. Thus, very little if any trauma iscaused to the body tissues of the patient in the use of my invention.v

After the outer cannula member 18 is in place, the inner cannula member12 is then inserted into the outer cannula member 18 throughout its fulllength until the inner end of the inner cannular member 12 bears againstthe inner end of the outer cannula member 18. This causes the leaves 3f)to expand to approximately the full diameter of the outer cannula member18 at its inner end. In this manner, a maximum air passageway isprovided for breathing by the patient. Of course, the outer cannulamember 1S may be inserted together with the inner cannula member 12 onlypartly inserted in the outer cannula member 1S. After the outer cannulamember 18 is in place, then the inner cannula member 12 may be insertedfully to expand the leaves 30 as mentioned before.

After the leaves 3@ have been expanded as mentioned, the inner cannularmember 12 is then locked into place if desired by use of the variouslocking means previously described. At all times, the inner cannulamember 12 is removable without disturbing the position of the outercannula member 18. When the inner cannula member 12 is removed, theleaves 3f) of the inner end of the outer cannula member 18 return totheir original positions, without causing any obstruction of the bore 16of the outer cannula member 1S. Thus, the outer cannula member 1S may beremoved also without the need for a stylet which is used by conventionaltracheostomy tubes at the present time. In this way, at all times, thepatient is able to breathe through his trachea using my tracheostomydevice with minimal discomfort compared to presently existingtracheostomy tubes.

Further, the conduit 79 may be connected by the beads 72 to a source ofgas such as oxygen or whatever gas is to be administered very easily.This may be done without any discomfort to the patient7 who continuesto' breathe through the bore 14 of the inner cannula member 12 while atthe same time receiving gas through the conduit 79. This feature isentirely absent in conventional tracheostomy tubes.

Although I have described my invention in detail with reference to theaccompanying drawings illustrating preferred forms of my invention, itis understood that numerous changes in the details of construction andarrangement of parts may be made without departing from the spirit andscope of the invention as hereinafter claimed I claim:

l. A tracheostomy tube for insertion into an opening of a patientstrachea comprising, an outer cannula member having a curvaturepermitting said cannula member to conform to the downward inner contourof the trachea after insertion, said cannula member terminating inflexible leaf members forming a cone-shaped inner end with interspacesbetween the leaf members to permit breathing of the patient through thetracheostomy tube while it is being inserted, and an inner cannulamember slidably inserted into the outer cannula member and having itsinner end when fully inserted bearing against said leaf members toexpand them to a maximum diameter equal to the diameter of the inner endof the outer cannula member.

2. A tracheostomy tube for insertion into an opening of a personstrachea comprising, an outer cannula member having a curvaturepermitting said cannula member to conform to the downward inner contourof the trachea after insertion and having a cone-shaped inner endterminating in liexible leaves with interspaces for breathing and havingthreadings around its outer circumference at its outer end, an innercannula member slidably inserted into the outer cannula member andhaving a longitudinal conduit in the circumference of its inner wall forpassage of gas, and a wing nut member having an inner annular lip at itstop and threading in its inner circumference which meshes with thethreading of the outer cannula member to maintain the inner cannulamember in position when fully inserted.

3. A tracheostomy tube for insertion into an opening of a personstrachea comprising, an outer cannula member having a curvaturepermitting said cannula member to conform with the inner contour of thetrachea after insertion and having a coneshaped inner end terminating inflexible leaves and with interspaces for breathing and formed at itsouter end into a platform with parallel lips defining a channel, aninner cannula member slidably inserted into the outer cannula member andhaving a conduit for passage of gas formed longitudinally in its innerWall, and with grooves cut into the outer circumference of its outerend, a breech member slidable Within Said channel and having twoprojecting arms With shoulders producing a friction t with said grooveswhen the breech member is pushed into locking position to maintain theinner cannula member in place when fully inserted.

References Cited bythe Examiner UNITED STATES PATENTS OTHER REFERENCESLancet: Adaptation of the Chevalier Jackson Trache- Ostomy Tube, Dec.23, 1961, p. 1388, 12S- 351.

RICHARD A. GAUDET, Primary Examiner.

1. A TRACHEOSTOMY TUBE FOR INSERTION INTO AN OPENING OF A PATIENT''STRACEA COMPRISING, AN OUTER CANNULA MEMBER HAVING A CURVATURE PERMITTINGSAID CANNULA MEMBER TO CONFORM TO THE DOWNWARD INNER CONTOUR OF THETRACHEA AFTER INSERTION, SAID CANNULA MEMBER TERMINATING IN FLEXIBLELEAF MEMBERS FORMING A CONE-SHAPED INNER END WITH INTERSPACES BETWEENTHE LEAF MEMBERS TO PERMIT BREATHING OF THE PATIENT THROUGH THETRACHEOSTOMY TUBE WHILE IT IS BEING INSERTED, AND AN INNER CANNULAMEMBER SLIDABLY INSERTED INTO THE OUTER CANNULA MEMBER AND HAVING ITSINNER END WHEN FULLY INSERTED BEARING AGAINST SAID LEAF MEMBERS TOEXPAND THEM TO A MAXIMUM DIAMETER EQUAL TO THE DIAMETER OF THE INNER ENDOF THE OUTER CANNULA MEMBER.